Klijn Adine J, Heida Jennie, Burger Desiree H C, Heyligers Jan M M, Pouwels Sjaak
Departments of Intensive Care Medicine, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands.
Departments of Neurology, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands.
Vasc Specialist Int. 2022 Jun 30;38:12. doi: 10.5758/vsi.220008.
We present a case of Brown-Séquard syndrome (BSS) after thoracic endovascular aortic repair (TEVAR) to treat Stanford type B aortic dissection. A 49-year-old male presented to the emergency department with acute tearing pain between the scapulae, connected to respiratory movements. Computed tomography showed Stanford type B aortic dissection from the left subclavian artery to the level of the 11th thoracic vertebra. Conservative treatment was initiated with intravenous antihypertensives. However, due to persistent pain and an increase in the aortic diameter with an intramural hematoma, TEVAR was performed. The patient developed symptoms suspicious of spinal cord ischemia postoperatively. A lesion limited to the left-sided spinal cord was observed on magnetic resonance imaging at the level of the 4th to 5th thoracic vertebra. BSS after TEVAR is a rare phenomenon with a fairly good prognosis, depending on the initial injury severity.
我们报告了一例在胸主动脉腔内修复术（TEVAR）治疗斯坦福B型主动脉夹层后出现的布朗-塞卡尔综合征（BSS）。一名49岁男性因肩胛间急性撕裂样疼痛并与呼吸运动相关而就诊于急诊科。计算机断层扫描显示从左锁骨下动脉至第11胸椎水平的斯坦福B型主动脉夹层。开始采用静脉注射抗高血压药物进行保守治疗。然而，由于持续疼痛以及主动脉直径增大并伴有壁内血肿，遂进行了TEVAR。患者术后出现疑似脊髓缺血的症状。在第4至5胸椎水平的磁共振成像上观察到左侧脊髓有局限性病变。TEVAR术后发生BSS是一种罕见现象，其预后相当良好，这取决于初始损伤的严重程度。
